DOCSLIB.ORG

A Review of the Use of Positive Reinforcement in Drug Courts Katherine Bascom Philadelphia College of Osteopathic Medicine

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Review of the Use of Positive Reinforcement in Drug Courts Katherine Bascom Philadelphia College of Osteopathic Medicine Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Psychology Dissertations Student Dissertations, Theses and Papers 2019 A Review of the Use of Positive Reinforcement in Drug Courts Katherine Bascom Philadelphia College of Osteopathic Medicine Follow this and additional works at: https://digitalcommons.pcom.edu/psychology_dissertations Part of the Clinical Psychology Commons Recommended Citation Bascom, Katherine, "A Review of the Use of Positive Reinforcement in Drug Courts" (2019). PCOM Psychology Dissertations. 509. https://digitalcommons.pcom.edu/psychology_dissertations/509 This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please contact [email protected]. Running head: POSITVE REINFORCEMENT IN DRUG COURTS Philadelphia College of Osteopathic Medicine School of Professional and Applied Psychology A REVIEW OF THE USE OF POSITIVE REINFORCEMENT IN DRUG COURTS By Katherine Bascom © 2019 Katherine Bascom Submitted in Partial Fulfillment of the Requirements of the Degree of Doctor of Psychology June 2019 DISSERTATION APPROVAL Th is is to certify th at the thesis presented to us by -----"/'-v-'-/k'-=l'--'1f1"'b"'-__..&"'-"'St;=6'-M____,___ _ ' on the ___,_9_fli ___ day of_----"-l't_._u,,_7_,__ _____, 2o_jj__, in partial fulfillment of the requirements for the degree of Doctor of Psychology, has been examined and is acceptable in both scholarship and literary quality. COMMITTEE MEMBERS' SIGNATURES Chairperson Chair, Department of Clinical Psychology Dean, School of Professional & Applied Psycholog POSITIVE REINFORCEMENT IN DRUG COURTS iii Acknowledgements I would first like to thank my committee members, Dr. David Festinger, Dr. Stephanie Felgoise, and Dr. Alexander Skolnick for their guidance and support throughout this process. Specifically, Dr. Festinger who helped me with the development of this study and provided me with timely edits and suggestions. Thank you to Dr. DiTomasso and Angelika for their assistance in creating my online survey. I also would like to thank my mom and dad, for their encouragement and support throughout this doctoral program and dissertation process. I greatly appreciate your commitment to my education, and I attribute my strong work ethic to you both. Lastly, I want to thank Greg Orton for inspiring my dissertation and work, and my boyfriend and friends for their love and support over the years. A huge thank-you to Doug MacDonald for his unconditional love, listening, support, understanding, sense of humor, and willingness to constantly move! Also, a huge thank you to Shanna Drinkwine, my favorite study pal. There are no stronger script writing, comps studying, STEPPS prepping, test taking teams than you and me! Thank you for all the laughs, adventures, cuddles with Cabella, and endless support over the last 5 years! I would not be here without you! And Mason, thank you for the unconditional love and happiness you gave me throughout my internship year. POSITIVE REINFORCEMENT IN DRUG COURTS iv Abstract There is a need to provide effective treatment for drug-abusing offenders, as evidenced by the explicitly supported relationship between drug use and crime (Anglin & Perrochet, 1998; Tonry & Wilson, 1990; McBride & McCoy, 1993). Drug policy in the United States has viewed drug abuse as a public safety concern or a public health concern (Marlowe, 2002). In 1989, the Miami Drug Court in Dade County, Florida developed a drug court system that is currently used nationwide. The model embodies a very strong behavioral orientation with clear expectations, as well as graduated sanctions and rewards for successive infractions and accomplishments. The use of positive reinforcement is a major component of contingency management (CM). CM is an evidence-based practice that promotes behavior change through systematic reinforcement of desired behaviors with rewards and punishment, or withholding of reinforcement for undesired behaviors (Higgins & Petry, 1999). This survey-based, mixed methods study assessed (1) the frequency of the use of positive reinforcement, currently or in the past, (2) stakeholders’ beliefs about the use of positive reinforcement in their programs, (3) the forms of positive reinforcement currently being used, and (4) the ways in which they implement positive reinforcement into their programs. Thirty-nine drug court coordinators from pre-trial/pre-sentencing drug courts in the United States of America participated in the survey. Of the 39 drug court coordinators who participated in this study, 37 reported that they use positive reinforcement/rewards in their drug court. Incentivizing productive behaviors is a key element that is listed under the NADCP’s adult drug court best practice standards. Incentives and rewards are critical elements of drug courts; these must be included in order to meet the acceptable standards of competencies as set forth by their association (NADCP, 2018). Keywords: drugs, treatment, drug courts, positive reinforcement POSITIVE REINFORCEMENT IN DRUG COURTS v TABLE OF CONTENTS ABSTRACT…………………………….……………..……………………………… iv INTRODUCTION…………………….…………….………………………………… 1 STATEMENT OF PROBLEM…….……………………………………………… 1 PURPOSE OF STUDY…….……………………………………………………. 31 RESEARCH QUESTION…………….…………………………………………. 33 METHOD………………….…………..……………….…………………………… 34 DESIGN……………………..…………………….…………………………...... 34 PARTICIPANTS……….………...…………………………………………..…. 34 INCLUSION AND EXCLUSION CRITERIA..…….………………………….. 35 MATERIALS………...…………………………………………………………. 35 PROCEDURE……………………………………..……………………………. 37 RESULTS…………………..……………...………………………………………... 39 ANALYSES………………………………...…………….…………………….. 39 DISCUSSION……………………….………………….………………………….. 70 REFERENCES………………….…………………….…………………………… 85 TABLES…………………….……………………………………………………... 95 FIGURES…………………………………………………………………………. 123 Running head: POSITVE REINFORCEMENT IN DRUG COURTS Introduction Statement of the Problem: There is a tremendous need to provide effective treatment for drug-abusing offenders, as evidenced by the explicitly supported relationship between drug use and crime (Anglin & Perrochet, 1998; Tonry & Wilson, 1990; McBride & McCoy, 1993). Drug users, specifically heavy users, are extremely likely to commit crimes (National Institute of Justice, 1999) to support their addiction. Although many offenders have drug abuse problems that are associated with their criminal lifestyles, only a small number of them receive treatment during their involvement with the criminal justice system. Only about 13-14% of drug and alcohol-using jail inmates participated in some form of substance abuse treatment since their admission to jail, and only about 15% of state prisoners reported participation in any treatment since their admission to prison (Mumola, 1999). Historically, drug policy in the United States has viewed drug abuse as a public safety concern or a public health concern (Marlowe, 2002). Over the years, many different public safety and public health approaches have been implemented. Some approaches combined both public safety and public health goals. However, all of these approaches failed to rehabilitate drug abusing offenders or reduce criminal recidivism (Marlowe, 2002). Therefore, in 1989, the Miami Drug Court in Dade County, Florida developed a drug court system that is currently used nationwide and addresses the underlying drug abuse problems of offenders and criminal recidivism. Drug courts identify drug-abusing offenders early on, following arrest, and offer them the voluntary opportunity to POSITIVE REINFORCEMENT IN DRUG COURTS 2 participate in a course of treatment and case management under the close supervision of the judge, instead of adjudication and potential incarceration (Burdon, Roll, Prendergast, & Rawson, 2001). During the 1990s, drug courts became increasingly popular. Since their development in 1989, over 3,000 drug courts have emerged across the United States (U. S. Department of Justice, 2016). These drug courts offer a new model as a response to the growing number of offenders with drug abuse problems, who cycle through the criminal justice systems without receiving or completing any treatment (Burdon et al., 2001). There are ten key components to the drug court model: 1) Integration of alcohol and other drug treatment services with justice system case processing; 2) a nonadversarial approach, with prosecution and a defense counsel that promotes public safety and protects participants’ due process rights; 3) early identification and prompt placement in the drug court program; 4) access to a continuum of alcohol, drug, and other related treatment and rehabilitation services; 5) abstinence monitoring by frequent alcohol and drug testing; 6) a coordinated strategy that governs drug court responses to participants’ compliance and noncompliance via graduated sanctions and rewards; 7) ongoing judicial interaction with each participant; 8) monitoring and evaluation of the achievement of program goals to gauge effectiveness; 9) interdisciplinary education to promote effective drug court planning, implementation, and operations, and 10) forging partnerships among drug courts, public agencies, and community-based organizations (U.S. Department of Justice, 1997). Drug court treatment programs vary according to individual clinical needs, but overall, there are many benefits to participation in a drug court program. Benefits
Load more

Recommended publications
  • Smoking Cessation Treatment at Substance Abuse Rehabilitation Programs
    SMOKING CEssATION TREATMENT AT SUBSTANCE ABUSE REHABILITATION PROGRAMS Malcolm S. Reid, PhD, New York University School of Medicine, Department of Psychiatry; Jeff Sel- zer, MD, North Shore Long Island Jewish Healthcare System; John Rotrosen, MD, New York University School of Medicine, Department of Psychiatry Cigarette smoking is common among persons with drug and alcohol n Nicotine is a highly use disorders, with prevalence rates of 80-90% among patients in sub- addictive substance stance use disorder treatment programs. Such concurrent smoking may that meets all of produce adverse behavioral and medical problems, and is associated the criteria for drug with greater levels of substance use disorder. dependence. CBehavioral studies indicate that the act of cigarette smoking serves as a cue for drug and alcohol craving, and the active ingredient of cigarettes, nicotine, serves as a primer for drug and alcohol abuse (Sees and Clarke, 1993; Reid et al., 1998). More critically, longitudinal studies have found tobacco use to be the number one cause of preventable death in the United States, and also the single highest contributor to mortality in patients treated for alcoholism (Hurt et al., 1996). Nicotine is a highly addictive substance that meets all of the criteria for drug dependence, and cigarette smoking is an especially effective method for the delivery of nicotine, producing peak brain levels within 15-20 seconds. This rapid drug delivery is one of a number of common properties that cigarette smok- ing shares with hazardous drug and alcohol use, such as the ability to activate the dopamine system in the reward circuitry of the brain.
    [Show full text]
  • Medications to Treat Opioid Use Disorder Research Report
    Research Report Revised Junio 2018 Medications to Treat Opioid Use Disorder Research Report Table of Contents Medications to Treat Opioid Use Disorder Research Report Overview How do medications to treat opioid use disorder work? How effective are medications to treat opioid use disorder? What are misconceptions about maintenance treatment? What is the treatment need versus the diversion risk for opioid use disorder treatment? What is the impact of medication for opioid use disorder treatment on HIV/HCV outcomes? How is opioid use disorder treated in the criminal justice system? Is medication to treat opioid use disorder available in the military? What treatment is available for pregnant mothers and their babies? How much does opioid treatment cost? Is naloxone accessible? References Page 1 Medications to Treat Opioid Use Disorder Research Report Discusses effective medications used to treat opioid use disorders: methadone, buprenorphine, and naltrexone. Overview An estimated 1.4 million people in the United States had a substance use disorder related to prescription opioids in 2019.1 However, only a fraction of people with prescription opioid use disorders receive tailored treatment (22 percent in 2019).1 Overdose deaths involving prescription opioids more than quadrupled from 1999 through 2016 followed by significant declines reported in both 2018 and 2019.2,3 Besides overdose, consequences of the opioid crisis include a rising incidence of infants born dependent on opioids because their mothers used these substances during pregnancy4,5 and increased spread of infectious diseases, including HIV and hepatitis C (HCV), as was seen in 2015 in southern Indiana.6 Effective prevention and treatment strategies exist for opioid misuse and use disorder but are highly underutilized across the United States.
    [Show full text]
  • Barriers and Solutions to Addressing Tobacco Dependence in Addiction Treatment Programs
    Barriers and Solutions to Addressing Tobacco Dependence in Addiction Treatment Programs Douglas M. Ziedonis, M.D., M.P.H.; Joseph Guydish, Ph.D., M.P.H.; Jill Williams, M.D.; Marc Steinberg, Ph.D.; and Jonathan Foulds, Ph.D. Despite the high prevalence of tobacco use among people with substance use disorders, tobacco dependence is often overlooked in addiction treatment programs. Several studies and a meta-analytic review have concluded that patients who receive tobacco dependence treatment during addiction treatment have better overall substance abuse treatment outcomes compared with those who do not. Barriers that contribute to the lack of attention given to this important problem include staff attitudes about and use of tobacco, lack of adequate staff training to address tobacco use, unfounded fears among treatment staff and administration regarding tobacco policies, and limited tobacco dependence treatment resources. Specific clinical-, program-, and system-level changes are recommended to fully address the problem of tobacco use among alcohol and other drug abuse patients. KEY WORDS: Alcohol and tobacco; alcohol, tobacco, and other drug (ATOD) use, abuse, dependence; addiction care; tobacco dependence; smoking; secondhand smoke; nicotine; nicotine replacement; tobacco dependence screening; tobacco dependence treatment; treatment facility-based prevention; co-treatment; treatment issues; treatment barriers; treatment provider characteristics; treatment staff; staff training; AODD counselor; client counselor interaction; smoking cessation; Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey obacco dependence is one of to the other. The common genetic vul­ stance use was considered a potential the most common substance use nerability may be located on chromo­ trigger for the primary addiction.
    [Show full text]
  • Cocaine Use Disorder
    COCAINE USE DISORDER ABSTRACT Cocaine addiction is a serious public health problem. Millions of Americans regularly use cocaine, and some develop a substance use disorder. Cocaine is generally not ingested, but toxicity and death from gastrointestinal absorption has been known to occur. Medications that have been used as substitution therapy for the treatment of a cocaine use disorder include amphetamine, bupropion, methylphenidate, and modafinil. While pharmacological interventions can be effective, a recent review of pharmacological therapy for cocaine use indicates that psycho-social efforts are more consistent over medication as a treatment option. Introduction Cocaine is an illicit, addictive drug that is widely used. Cocaine addiction is a serious public health problem that burdens the healthcare system and that can be destructive to individual lives. It is impossible to know with certainty the extent of use but data from public health surveys, morbidity and mortality reports, and healthcare facilities show that there are millions of Americans who regularly take cocaine. Cocaine intoxication is a common cause for emergency room visits, and it is one drug that is most often involved in fatal overdoses. Some cocaine users take the drug occasionally and sporadically but as with every illicit drug there is a percentage of people who develop a substance use disorder. Treatment of a cocaine use disorder involves psycho-social interventions, pharmacotherapy, or a combination of the two. 1 ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com Pharmacology of Cocaine Cocaine is an alkaloid derived from the Erthroxylum coca plant, a plant that is indigenous to South America and several other parts of the world, and is cultivated elsewhere.
    [Show full text]
  • Alcohol Use Disorder
    Section: A B C D E Resources References Alcohol Use Disorder (AUD) Tool This tool is designed to support primary care providers (family physicians and primary care nurse practitioners) in screening, diagnosing and implementing pharmacotherapy treatments for adult patients (>18 years) with Alcohol Use Disorder (AUD). Primary care providers should routinely offer medication for moderate and severe AUD. Pharmacotherapy alone to treat AUD is better than no therapy at all.1 Pharmacotherapy is most effective when combined with non-pharmacotherapy, including behavioural therapy, community reinforcement, motivational enhancement, counselling and/or support groups. 2,3 TABLE OF CONTENTS pg. 1 Section A: Screening for AUD pg. 7 Section D: Non-Pharmacotherapy Options pg. 4 Section B: Diagnosing AUD pg. 8 Section E: Alcohol Withdrawal pg. 5 Section C: Pharmacotherapy Options pg. 9 Resources SECTION A: Screening for AUD All patients should be screened routinely (e.g. annually or when indicators are observed) with a recommended tool like the AUDIT. 2,3 It is important to screen all patients and not just patients eliciting an index of suspicion for AUD, since most persons with AUD are not recognized. 4 Consider screening for AUD when any of the following indicators are observed: • After a recent motor vehicle accident • High blood pressure • Liver disease • Frequent work avoidance (off work slips) • Cardiac arrhythmia • Chronic pain • Rosacea • Insomnia • Social problems • Rhinophyma • Exacerbation of sleep apnea • Legal problems Special Patient Populations A few studies have reviewed AUD in specific patient populations, including youth, older adults and pregnant or breastfeeding patients. The AUDIT screening tool considered these populations in determining the sensitivity of the tool.
    [Show full text]
  • DIAGNOSIS REFERENCE GUIDE A. Diagnostic Criteria for Substance
    ALCOHOL & OTHER DRUG SERVICES DIAGNOSIS REFERENCE GUIDE A. Diagnostic Criteria for Substance Use Disorder See DSM-5 for criteria specific to the drugs identified as primary, secondary or tertiary. P S T (P=Primary, S=Secondary, T=Tertiary) 1. Substance is often taken in larger amounts and/or over a longer period than the patient intended. 2. Persistent attempts or one or more unsuccessful efforts made to cut down or control substance use. 3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from effects. 4. Craving or strong desire or urge to use the substance 5. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home. 6. Continued substance use despite having persistent or recurrent social or interpersonal problem caused or exacerbated by the effects of the substance. 7. Important social, occupational or recreational activities given up or reduced because of substance use. 8. Recurrent substance use in situations in which it is physically hazardous. 9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. 10. Tolerance, as defined by either of the following: a. Markedly increased amounts of the substance in order to achieve intoxication or desired effect; Which:__________________________________________ b. Markedly diminished effect with continued use of the same amount; Which:___________________________________________ 11. Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for the substance; Which:___________________________________________ b.
    [Show full text]
  • Treatment of Patients with Substance Use Disorders Second Edition
    PRACTICE GUIDELINE FOR THE Treatment of Patients With Substance Use Disorders Second Edition WORK GROUP ON SUBSTANCE USE DISORDERS Herbert D. Kleber, M.D., Chair Roger D. Weiss, M.D., Vice-Chair Raymond F. Anton Jr., M.D. To n y P. G e o r ge , M .D . Shelly F. Greenfield, M.D., M.P.H. Thomas R. Kosten, M.D. Charles P. O’Brien, M.D., Ph.D. Bruce J. Rounsaville, M.D. Eric C. Strain, M.D. Douglas M. Ziedonis, M.D. Grace Hennessy, M.D. (Consultant) Hilary Smith Connery, M.D., Ph.D. (Consultant) This practice guideline was approved in December 2005 and published in August 2006. A guideline watch, summarizing significant developments in the scientific literature since publication of this guideline, may be available in the Psychiatric Practice section of the APA web site at www.psych.org. 1 Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline may be reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx. AMERICAN PSYCHIATRIC ASSOCIATION STEERING COMMITTEE ON PRACTICE GUIDELINES John S. McIntyre, M.D., Chair Sara C. Charles, M.D., Vice-Chair Daniel J. Anzia, M.D. Ian A. Cook, M.D. Molly T. Finnerty, M.D. Bradley R. Johnson, M.D. James E. Nininger, M.D. Paul Summergrad, M.D. Sherwyn M.
    [Show full text]
  • Substance Use Disorder Defined by NIDA and SAMHSA
    Substance Use Disorder defined by NIDA and SAMHSA: NIDA (National Institute on Drug Abuse) defines SUD/Addiction as: What is drug addiction? Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Addiction is the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances. Why study drug use and addiction? Use of and addiction to alcohol, nicotine, and illicit drugs cost the Nation more than $740 billion a year related to healthcare, crime, and lost productivity.1,2 In 2016, drug overdoses killed over 63,000 people in America, while 88,000 died from excessive alcohol use.3,4 Tobacco is linked to an estimated 480,000 deaths per year.5 (Hereafter, unless otherwise specified, drugs refers to all of these substances.) How are substance use disorders categorized? NIDA uses the term addiction to describe compulsive drug seeking despite negative consequences. However, addiction is not a specific diagnosis in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)—a diagnostic manual for clinicians that contains descriptions and symptoms of all mental disorders classified by the American Psychiatric Association (APA). In 2013, APA updated the DSM, replacing the categories of substance abuse and substance dependence with a single category: substance use disorder, with three subclassifications—mild, moderate, and severe. The symptoms associated with a substance use disorder fall into four major groupings: impaired control, social impairment, risky use, and pharmacological criteria (i.e., tolerance and withdrawal).
    [Show full text]
  • DSM-5 Diagnoses and New ICD-10-CM Codes
    DSM-5 DiAgnoses And New ICD-10-CM Codes As Ordered in the DSM-5 Classification DSM-5 Recommended DSM-5 Recommended Disorder ICD-10-CM Code for use ICD-10-CM Code for use through September 30, 2017 beginning October 1, 2017 Avoidant/Restrictive Food Intake Disorder F50.89 F50.82 Alcohol Use Disorder, Mild F10.10 F10.10 Alcohol Use Disorder, Mild, In early or sustained remission F10.10 F10.11 Alcohol Use Disorder, Moderate F10.20 F10.20 Alcohol Use Disorder, Moderate, In early or sustained F10.20 F10.21 remission Alcohol Use Disorder, Severe F10.20 F10.20 Alcohol Use Disorder, Severe, In early or sustained F10.20 F10.21 remission Cannabis Use Disorder, Mild F12.10 F12.10 Cannabis Use Disorder, Mild, In early or sustained F12.10 F12.11 remission Cannabis Use Disorder, Moderate F12.20 F12.20 Cannabis Use Disorder, Moderate, In early or sustained F12.20 F12.21 remission Cannabis Use Disorder, Severe F12.20 F12.20 Cannabis Use Disorder, Severe, In early or sustained F12.20 F12.21 remission Phencyclidine Use Disorder, Mild F16.10 F16.10 Phencyclidine Use Disorder, Mild, In early or sustained F16.10 F16.11 remission Phencyclidine Use Disorder, Moderate F16.20 F16.20 Phencyclidine Use Disorder, Moderate, In early or F16.20 F16.21 sustained remission Phencyclidine Use Disorder, Severe F16.20 F16.20 Phencyclidine Use Disorder, Severe, In early or sustained F16.20 F16.21 remission Other Hallucinogen Use Disorder, Mild F16.10 F16.10 Other Hallucinogen Use Disorder, Mild, In early or F16.10 F16.11 sustained remission Other Hallucinogen Use Disorder,
    [Show full text]
  • Substance Use Disorder Brochure
    Substance Use Disorder & Addictioniction What is substance use disorder and addiction? Substance use disorder is using drugs or alcohol even though doing so causes problems in your life. Addiction is a physical or mental dependence on drugs or alcohol. This means when you stop using drugs or alcohol you could get sick. Addiction can also mean that you cannot stop thinking about substances. It’s bad for your health Substance use disorder affects you and those around you. Substance use disorder problems can lead to poor health, violence and arrest. It can also lead to you injuring others or even suicide. Studies show people with a substance addiction may also suffer from other mental health problems like depression. A person with a substance use disorder problem is not a bad person. They may need help from an expert. Without help, problems can get worse. Signs of a possible problem • Drinking in risky situations (while driving, swimming, etc.) • Continued use of alcohol or drugs despite personal or social problems • Obligations at work, home or school are neglected due to drinking or drug use • Legal problems related to drinking or drug use (domestic violence, assault or DUI) This page is intentionally left blank. Who offers substance use disorder services? Your Doctor: They can treat you or refer you to a specialist. Nurse Practitioner: They can be experts in substance use disorder and addiction, and can give medicine in most states. Therapist: Can provide psychotherapy, but cannot prescribe medicine. Some types of therapists are Licensed Mental Health Counselors (LMCH), and Licensed Marriage and Family Therapists (LMFT).
    [Show full text]
  • Best Practices Across the Continuum of Care for Treatment of Opioid Use Disorder
    www.ccsa.ca • www.ccdus.ca Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder August 2018 Sheena Taha, PhD Knowledge Broker Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder This document was published by the Canadian Centre on Substance Use and Addiction (CCSA). Suggested citation: Taha, S. (2018). Best Practices across the Continuum of Care for Treatment of Opioid Use Disorder. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. © Canadian Centre on Substance Use and Addiction, 2018. CCSA, 500–75 Albert Street Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: [email protected] Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. This document can be downloaded as a PDF at www.ccsa.ca. Ce document est également disponible en français sous le titre : Pratiques exemplaires dans le continuum des soins pour le traitement du trouble lié à l’usage d’opioïdes ISBN 978-1-77178-507-5 Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder Table of Contents Executive Summary ..................................................................................................... 1 Introduction ................................................................................................................. 2 Method...................................................................................................................
    [Show full text]
  • THE COMMUNITY REINFORCEMENT APPROACH Development and Effectiveness of CRA an UPDATE of the EVIDENCE the Most Influential Behaviorist of All Times, B
    COMMUNITY REINFORCEMENT APPROACH THE COMMUNITY REINFORCEMENT APPROACH Development and Effectiveness of CRA AN UPDATE OF THE EVIDENCE The most influential behaviorist of all times, B. F. Skinner, largely considered punishment to be an ineffective method Robert J. Meyers, Ph.D.; Hendrik G. Roozen, Ph.D.; for modifying human behavior (Skinner 1974). Thus it and Jane Ellen Smith, Ph.D. was no surprise that, many years later, research discovered that substance use disorder treatments based on confrontation were largely ineffective in decreasing the use of alcohol The Community Reinforcement Approach (CRA), and other substances (Miller and Wilbourne 2002, originally developed for individuals with alcohol use Miller et al. 1998). Nate Azrin already was convinced disorders, has been successfully employed to treat a variety of this back in the early 1970s, when he designed an inno­ of substance use disorders for more than 35 years. Based on vative treatment for alcohol problems: the Community operant conditioning, CRA helps people rearrange their Reinforcement Approach (CRA). Azrin believed that it lifestyles so that healthy, drug­free living becomes was necessary to alter the environment in which people rewarding and thereby competes with alcohol and drug with alcohol problems live so that they received strong use. Consequently, practitioners encourage clients to reinforcement for sober behavior from their community, become progressively involved in alternative non­ including family, work, and friends. As part of this strate­ substance­related pleasant social activities, and to work on gy, the program emphasizes helping clients discover new, enhancing the enjoyment they receive within the enjoyable activities that do not revolve around alcohol, and “community” of their family and job.
    [Show full text]